Recent research findings indicate that with older adulthood, there are functional decrements in spatial cognition and more specially, in the ability to mentally represent and effectively plan motor actions. A typical finding is a significant over- or underestimation of one’s actual physical abilities with movement planning—planning that has implications for movement efficiency and physical safety. A practical, daily life example is estimation of reachability—a situation that for the elderly may be linked with fall incidence. A strategy used to mentally represent action is the use of motor imagery—an ability that also declines with advancing older age. This brief review highlights research findings on mental representation and motor imagery in the elderly and addresses the implications for improving movement efficiency and lowering the risk of movement-related injury.